Kornimate/medical-research-clean huggingface dataset:
vaginal misoprostol and dinoprostone prior to copper intrauterine device insertion in women

Conditions: IUCD Complication

Summary: to compare the effect of vaginal dinoprostone versus vaginal misoprostol administered before the copper intrauterine device(iud) insertion in reducing iud insertion pain and the difficulty in inserting the iud in multiparous overweight and obese women

long-acting reversible contraception methods are highly effective methods for reduction of the unplanned pregnancy rate worldwide. the intrauterine device is a single procedure that provides reliable, effective and long term contraception for many women. however, the insertion procedure can be associated with a troublesome degree of pain that prevent some women from choosing its use. different interventions have been described to decrease pain perception during intrauterine device insertion with no agreement on an effective one.

Eligibility criteria:
inclusion criteria: * multi parous women requesting copper iud insertion * body mass index more than 25 exclusion criteria: * pregnancy, * null parous women, * contraindications or allergy to dinoprostone or misoprostol,contraindication to iud insertion, * untreated active cervicitis or vaginitis, * undiagnosed abnormal uterine bleeding
oral cleft prevention program

Conditions: Cleft Lip; Cleft Palate

Summary: the purpose of this study is to asses if taking 4 mg of folic acid per day at preconception and during the first three months of pregnancy decreases the risk of having a child with cleft lip and palate compared to 0.4 mg folic acid for women who have an oral cleft or have had previously child with an oral cleft.

cleft lip and palate is a common and burdensome birth defect that has large health ramifications and requires surgical, speech, behavioral, dental, and medical interventions. there is some evidence suggesting that taking folic acid particularly at large doses during preconception and first trimester of pregnancy may decrease the risk of oral cleft recurrence, which is the risk of having a child with an oral cleft for women who have an oral cleft or who have had a child with a cleft. however this evidence is based on study designs that are incapable of contributing the preventive effects to folic acid with adequate confidence, and the real effect of folic acid on cleft recurrence prevention remains to be identified. taking 4 mg of folic acid per day at preconception and first trimester of pregnancy has also been shown to prevent the recurrence of neural tube defects by up to 70%, providing further support to evaluate this intervention for oral cleft recurrence. this study evaluates the effects of supplementation with 4 versus 0.4 mg of folic acid per day at preconception and during the first three months of pregnancy on recurrence of cleft lip and palate. up to 6000 women will be randomly assigned to 4 versus 0.4 mg groups. the primary aim is to compare the recurrence rates in the offspring of trial mothers in the two groups. secondary aims are to compare the two groups on several outcomes including miscarriage, twinning, pre-eclampsia, serum and red cell folate levels, severity of oral clefts and occurrence of other birth defects in the offspring of trial mothers, and birth weight and gestational age of trial babies, and to compare the recurrence in the two groups to that in historic controls.

Eligibility criteria:
inclusion criteria: * women with cleft lip with/out palate (clp), 16 to 45 years of age registered at the study clinics in brazil or women (16 to 45 years of age) with at least one natural child of any age with clp registered at the study clinics. * women must reside in the catchment area of the study, which includes the states where the study clinics are located and surrounding states. exclusion criteria: * consanguineous couples (up to third degree, i.e. first cousins or closer). * pregnany at the time of recruitment. women will be recontacted later at an appropriate time for participation in the study. * couples either one of which have been sterilized. * taking any form of seizure medication. * planning to move outside of the study catchment area within the next year. * b12 deficiency (\<174 pg/ml or 129.15 pmol/l). * being allergic to folic acid.
effects of direct antiviral agents on hepatitis c virus arthropathy

Conditions: Hepatitis C

Summary: the prevalence of hcv infection in egypt is 14.7%. hcv is both a hepatotropic and a lymphotropic virus, it may exert a chronic stimulus on the immune system with both t and b lymphocyte alterations. in addition to cryoglobulinaemic vasculitis, hcv may trigger different immune-mediated extrahepatic disorders. a variable combination of hcv with other unknown enviromental and/or hostgenetic cofactors may lead to different clinical phenotypes that characterise hcv syndrome. patients who have hcv -related arthropathy are accounted for by 2 clinical subsits: rheumatoid-like arthritis and cryoglobulin-related arthritis. patients with mild arthritis, conservative manegement using analgesics with anti- inflammatory activity is recommended. in patients who have contraindications to their use, short term low dose prednisone is an option. in hcv infection with concomitant ra, acr guidelines published in 2008 provided recommendations pertaining to these of dmards that are based on the severity of liver disease using the child- pugh- turcotte classification. for patients with severe cryoglobulinaemia such as severe debilitating disease or systemic in improvement, a combination of immunosuppressive and antiviral therapy is preferred. it has been found that antiviral therapy with interferon immunosuppressive and antiviral therapy is preferred. it has been found that antiviral therapy with interferon improves the musculoskeletal manifestations in hcv arthropathy. the direct antiviral agents seems very promising in treatment of hcv arthropathy. as hcv genotype 4 is the most common genotype in egypt, the effective optional antiviral agents are sofosbuvir, daclatasvir, ledipasvir, paritaprevir, velpatasvir, ombitasvir and simeprevir.


Eligibility criteria:
inclusion criteria: * antiviral patients with arthropathy concomitant hcv (proved by pcr testing). exclusion criteria: * patients with child-pugh b and child-pugh c decompensated cirrhosis. * patients more that 60 years. * patients with chronic infection e.g.(pulmonary t.b). * patients with organ failure e.g.( heart failure, respiratory failure). * patients with ckd with gfr lead that 60 ml/ ministry/1.73m2. * patients on immunosuppressive agents. * patients with hbv- coinfection.
gamification of neurorehabilitation-centric hand exercises post stroke or brain injury

Conditions: Stroke; Engagement, Patient

Summary: stroke is the leading cause of adult disability worldwide. often, severe neurological deficits occur after a stroke and roughly 70% of all stroke survivors have some form of hand function disability. to improve the lives of those with hand function disability, iregained inc. has created the myhandtm system. the myhandtm system is a smart-mechatronic device programmed with proprietary hand function training regiments (protocols) based on deep research in neuroplasticity. it provides a highly unique and targeted approach to hand function rehabilitation with the help of the aforementioned protocols delivered with gamified training techniques. the gamified format of the protocols allows for better patient engagement, thus allowing for more effective and efficient therapy. individuals who have sustained a stroke 5 months or earlier (considered to be chronic stroke survivors) will be eligible to participate in this study. participants will undergo a 2-hour training session, 2-3 days per week, over 12 weeks, for a total of 30 sessions. hand function therapy will be administered in a specific and gamified manner to enhance rehabilitation of the hand and provide participants with greater opportunity to regain hand function over the course of the study. the goal of this research project is to understand how a gamified approach to hand function rehabilitation impacts engagement and motivation. this understanding will directly translate into the development of more efficient and effective modes of therapy.


Eligibility criteria:
inclusion criteria: * sustained a single stroke exclusion criteria: * severe spasticity or contractures (2 or less in the cmsa) or any other musculoskeletal or neuromuscular disorders that compromise sensation or other neuromuscular parameters will be excluded from the study. prospective participants who are incapable of providing consent to participate in the research study will also be excluded (determined by an mmse score of 23 or less).
a study to evaluate safety and efficacy of sage-547 in participants with moderate postpartum depression (547-ppd-202c)

Conditions: Postpartum Depression

Summary: the purpose of this study was to determine if sage-547 injection infused intravenously at up to 90 μg/kg/h for 60 hours reduces depressive symptoms in participants with moderate postpartum depression (ppd) compared to placebo injection as assessed by the change from baseline in hamilton rating scale for depression (ham-d) total score.


Eligibility criteria:
key inclusion criteria: * participant either must have ceased lactating at screening; or if still lactating or actively breastfeeding at screening, agreed to temporarily cease giving breastmilk to their infant(s). * participant had a major depressive episode that began no earlier than the third trimester and no later than the first 4 weeks following delivery, as diagnosed by structured clinical interview for dsm-iv axis i disorders (scid-i). * participant had a ham-d total score of ≥20 and ≤25 at screening and day 1 (prior to dosing). * participant was ≤ six months postpartum. * participant was amenable to intravenous therapy. key exclusion criteria: * active psychosis. * attempted suicide associated with index case of postpartum depression. * medical history of bipolar disorder. note: other protocol-defined inclusion/exclusion criteria applied.

Keywords: moderate postpartum depression sage-547
medication development in alcoholism: investigating glucocorticoid antagonists

Conditions: Alcoholism

Summary: the primary hypotheses under test are that alcohol dependent subjects treated with mifepristone will report decreased craving for alcohol following alcohol exposure in the laboratory and report significantly less drinking under naturalistic conditions, than those treated with placebo.


Eligibility criteria:
inclusion criteria: * male or female volunteers, 18-65 years of age * meets diagnostic and statistical manual of mental disorders fourth addition (dsm-iv) criteria for current alcohol dependence * subjects will not be seeking treatment because the medication studies are not treatment trials * subjects must be abstinent a minimum of 3 days (but not more than 7 days) prior to the human lab session * negative breath alcohol concentration (bac) and a clinical institute withdrawal assessment-alcohol (ciwa-a) score of \< 8 at screening and time of lab session to eliminate acute alcohol or withdrawal effects on dependent measures * subjects must be able to complete and understand questionnaires and study procedures in english and sign an informed consent exclusion criteria: * significant medical disorders that will increase potential risk or interfere with study participation as determined by the study physician * female subjects with childbearing potential who are pregnant, nursing, or refuse to use double barrier (non-hormonal) methods of birth control for the duration of the study and one month thereafter * meets dsm-iv criteria for a major axis i disorder including mood or anxiety disorders or substance dependence disorders other than alcohol or nicotine dependence * history of allergy or hypersensitivity to the study drugs or the ingredients * treatment within the month prior to screening with 1.) an investigational drug or vaccine; 2.) drugs that may influence study outcomes, e.g., disulfiram (antabuse), naltrexone (revia), acamprosate (campral), anticonvulsants, antidepressants. * in need of or currently taking any psychoactive medications.

Keywords: alcohol relapse
feasibility of a physiotherapy-led follow-up programme in adult critical illness survivors

Conditions: Post Intensive Care Unit Syndrome

Summary: survivors of critical illness might suffer from ongoing physical, cognitive and emotional impairments after being discharged home. furthermore, several studies have shown that these patients might have a need for ongoing support. however, up until now, it is not known what the optimal follow-up programme for survivor of critical illness after discharge home should look like or which exact patient population would benefit the most. due to these reasons, it is important to further investigate, how these patients can be optimally supported to recover from their critical illness. the primary aim of this study is to assess, whether a physiotherapy-led follow-up programme is feasible in adult survivors of critical illness after discharge home in the county hospital of winterthur. furthermore, the investigators evaluate the influence of this physiotherapy-led follow-up programme on health related quality of life, exercise capacity, general muscle strength, inspiratory muscle strength, anxiety and depression. all of the anticipated 20 patients will partake in the follow-up programme, which will consist out of a nine weeks exercise programme and four education sessions. during the exercise programme, the patients will exercise twice per week under supervision and once by themselves. the supervised exercise sessions will consist out of a combination of a cardiopulmonary and strength training and the unsupervised session will be a physical activity, which the participants like doing. furthermore, they will participate in education sessions, where they learn things about the intensive care unit, the post-intensive care syndrome, relaxation techniques and how to carry on with exercising. the whole study will last about ten months and forms a part of a master thesis.


Eligibility criteria:
inclusion criteria: * signed informed consent after being informed * adult patient (\>18 years), who was treated in the icu of the county hospital of winterthur and who was ventilated for longer than 48 hours * patient, who received inpatient rehabilitation and then was discharged home exclusion criteria: * head or spinal cord injury, leading to neurological deficits * receiving palliative care * fractures diminishing mobility * principal diagnosis of chronic obstructive pulmonary disease (copd) * principal diagnosis of myocardial infarction, heart failure or reanimation * principal diagnosis of stroke or cerebral bleeding * previous diagnosis of dementia or cognitive impairment * inability of the participant to follow the procedures of the study, e.g. due to language problems, psychological disorders, etc.; * enrolment of the investigator, his/her family members, employees and other dependent persons
chest ct using low-concentration iodine contrast media

Conditions: Pulmonary Disease

Summary: this study aims to evaluate the quality of images when low-concentration iodine contrast agents is used in chest ct with low tube voltage and if they can be used in routine imaging. the primary endpoint of the study was the quality of the image and comparison of chest ct by using low and conventional concentration iodine contrast agents with low tube voltage and chest ct by using the conventional concentration iodine contrast agents with the conventional tube voltage; the secondary endpoint is optimizing chest ct protocol using an iodine contrast agent.

with persistent advances in computed tomography (ct) technology, there is a need for continuous investigation and optimization of injection protocols. intravenous contrast enhancement in ct is affected by various interacting factors, which can be roughly divided into 3 categories: patient, contrast medium and ct scanning. over the last decade, evolutions in technology has resulted in faster cts with improved temporal and spatial resolutions; newer techniques such as iterative reconstruction has enabled lower tube voltage (expressed in units of peak kilovolt, kvp) and lower dose cts with less noise and preserved image quality. as ct scanning is one of the major determinants of contrast enhancement at ct, such technological advances in ct can be assumed to have invariably caused alterations in the degree of contrast enhancement at ct. however, despite changes in ct scanning techniques, recommended contrast injection protocol for chest ct with enhancement (cect), including concentration of iodine contrast material, have not changed over the last decade; for routine chest cect, the use of 300-350 mgi/ml iodine contrast material has been recommended without definitely stating the precise reasons using that specific iodine concentration. therefore, the aim of this study was to evaluate the image quality of low voltage chest cect using lccm(low-concentration iodinated contrast media.

Eligibility criteria:
inclusion criteria: * patients aged 19 years or older, weighing less than 90 kg, and bmi less than 30 who underwent contrast-enhanced chest ct alone exclusion criteria: 1. under the age of 18 2. cases where contrast-enhanced ct cannot be performed 3. heart failure 4. pregnancy 5. if patients cannot voluntarily give written consent to participate in this clinical trial 6. in the case of an anatomical deformation that may interfere with image analysis in the previous image 7. patients with a history of hypersensitivity to iobrix, components of iobrix, and iodine-based drugs 8. patients with severe thyroid disease (iodine may accumulate in the thyroid gland and worsen symptoms.) 9. those who are judged unsuitable by the tester for other reasons patients aged 19 years or older, weighing less than 90 kg, and bmi less than 30 who underwent contrast-enhanced chest ct alone
assessment of stress levels and depressive and anxiety symptoms in patients with copd

Conditions: COPD; Anxiety State; Stress; Depressive Symptoms; Mood Disorders

Summary: the aim of the study was to assess the levels of depression, anxiety and stress in patients with copd qualified for in-hospital pulmonary rehabilitation program

chronic obstructive pulmonary disease (copd), manifested by coughing, shortness of breath, sputum production, wheezing and reduced physical performance, is one of the most frequently diagnosed lung diseases. anxiety and depression have been found to increase the number of acute exacerbations and hospitalizations (thus reducing quality of life), weight, appetite, sleep disorders, fatigue or loss of energy, lack of concentration, pessimism about the future and suicidality. anxiety has been estimated to occur in 21-96% and depression in 27-79% of patients with copd, values that are higher than for the general population or other chronic diseases. pulmonary rehabilitation leads to the improvement to the physical capacity and overall fitness of the patients with copd allowing restoration of independence in daily functioning. psychological support is required in order to reduce the negative psychological symptoms related to both the pulmonary disease itself and the comorbidities. in the presented study, the aim was to assess the prevalence of levels of depression, anxiety and stress in patients with copd qualified for in-hospital pulmonary rehabilitation program. the program includes the following elements: three weeks of pulmonary rehabilitation conducted in an outpatient care facility: * 5- time a week for 30 minutes a specific respiratory exercises- relaxation exercises for breathing muscles, exercises to increase breathing, prolonged exhalation exercise, chest percussion * 5- time a week for 20-30 min training on a cycle ergometer * 5- time a week for 30 minutes a fitness and respiratory exercises - coordination and balance exercises, stretching exercises * relaxation training by schultz. the technique involves the daily practice of sessions that last around 15 minutes. during each session, the practitioner repeats a set of visualisations that induce a state of relaxation.

Eligibility criteria:
inclusion criteria: * diagnosed as copd; * pulmonary rehabilitation conducted in ward settings; exclusion criteria: * inability to self-complete the research questionnaires; * presence of the following issues at the time of the examination or in the medical data: disturbances of consciousness, psychotic symptoms or other serious psychiatric disorders; * initiation of psychiatric treatment during the research project; * the patient's refusal at any stage of the research project.

Keywords: pulmonary rehabilitation depression anxiety stress
the effect of urinating through the zipper or by pulling down the trousers on uroflowmetry parameters in luts

Conditions: Benign Prostatic Hyperplasia; Micturition Disorder; Urinary Obstruction; Urinary Tract Disease; Urologic Diseases

Summary: there are many factors that affect uroflowmetry parameters. one of these is the urination position. research has mostly focused on standing and sitting urination positions. however, those who prefer the standing position as a habit can urinate by opening the zipper or lowering the trousers. although the effect of these two applications on uroflowmetry parameters in healthy men has been investigated in only one study, their effect on patients with lower urinary tract symptoms has not been examined.


Eligibility criteria:
inclusion criteria: * having lower urinary tract symptoms due to bpo exclusion criteria: * having a neurogenic bladder * previous prostate surgery * having urethral stricture * bladder neck stenosis * having a bladder stone or tumor * having a urinary system infection * finding a suspicious nodule in digital rectal examination

Keywords: benign prostatic obstruction uroflowmetry urodynamics
randomized study on neoadjuvant radio-chemotherapy in rectal carcinoma dukes b and c

Conditions: Rectal Cancer Dukes B, Dukes C

Summary: this clinical investigation examined the influence of preoperative radiotherapy in combination with postoperative 5-fluorouracil + leucovorin chemotherapy vs. 5-fluorouracil + leucovorin + mab 17-1a chemo-immunotherapy on patients' local recurrence rate and overall survival time following surgery for rectal carcinoma dukes b or c (t2-4, n0-3, m0).


Eligibility criteria:
inclusion criteria: * patients with histologically verified operable rectal cancer dukes b and c (stage ii, t2-4, n0-3, m0), r0 * age: 18-80 years * karnofsky performance status \> 80 * adequate bone marrow reserve (leukocytes \> 4,000, thrombocytes \> 105/mm3, hb \> 10g %), renal and hepatic functions (total bilirubin and creatinine \< 1.25 x uln) exclusion criteria: * colon cancer * r1, r2; carcinosis peritonei * start of treatment \> 42 days postop; other adjuvant radiotherapy, chemotherapy or immunotherapy * previous application of a murine or chimeric monoclonal antibody or antibody fragment * medical therapy with steroids, cyclosporin or antithymocyte globulin within 3 months pre-study * known hypersensitivity to animal protein * serious concomitant disease: hiv, chronically inflammatory intestine, diabetes mell. gravis, cerebral seizure disorder, et al. * pregnancy or lactation

Keywords: fluorouracil leucovorin mab 17-1a rectal cancer